EDWARD A BLANZY - Medical Doctor License in Illinois | # 125027498

EDWARD A BLANZY

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027498

License Status

EXPIRED

Business

N

First Name

EDWARD

Middle

A

Last Name

BLANZY

Business Name

EDWARD A BLANZY

Original Issue Date

08/12/1991

Effective Date

08/12/1991

Expiration Date

08/08/1995

State

IL

Specialty/Qualifier

Urology

Ever Disciplined

N

LastModifiedDate

09/22/2006